Individual
MS. ANGELA PUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A
Contact information
Practice address
12020 PACIFIC ST, OMAHA, NE 68154-3507
(800) 259-0287
Mailing address
12020 PACIFIC ST, OMAHA, NE 68154-3507
(804) 869-4056
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2306604238
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2306604238
PTA LICENSE
VA
Enumeration date
04/15/2019
Last updated
06/11/2019
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